A panel made up mostly of doctors and health officials conducted the review and will conduct a detailed study of infant mortality in the Native population in the next six months.

The rates have fallen over the years, but 11.4 of every 1,000 Alaska Natives born between 1992 and 2001 died before their first birthday, said review co-author Brad Gessner. That's almost twice the rate of non-Native Alaska infant deaths - about six for every 1,000 live births over the same period, he said.

Health care providers in Alaska have battled high infant-mortality rates for decades, especially in the bush. The review attempts to analyze every infant death in Alaska as part of that effort, Gessner said.

The panel analyzed 755 of 759 known infant deaths during the 10 years, he said.

Alaska's total infant mortality has been lowered to almost the national average, to 7.3 deaths per 1,000 during the review period. The national infant mortality rate was 6.8 in 2001, according to the review.

Still, Gessner said, Alaska consistently ranks among the worst 10 states for mortality of infants in the post-neonatal period, between 4 weeks and 1 year old. Alaska's high rates of sudden infant death syndrome - which have been the highest in the nation in the last decade - have been a key factor, he said.

The SIDS rate among Natives is more than double the non-Native rate.

Gessner said no one knows exactly why infant mortality among Alaska Natives is high.

The lack of medical services in the Bush doesn't appear to be as large a factor as people think, he said. Rural and urban Natives have equally high infant-death rates. The disparity between Natives and non-Natives also is the same in rural and urban areas.

"It's not a rural issue and it's not an access-to-care issue," he said. "There are other things going on."

The state, working with the federal Centers for Disease Control and Prevention, each year asks 20 percent of new mothers in Alaska to fill out a questionnaire, he said.

The latest available responses, collected in 2001, showed:

 Native mothers were more than twice as likely report smoking during pregnancy than Caucasian mothers. Smoking is linked to SIDS for unknown reasons.

 Native infants are more than twice as likely to suffer physical abuse - such as shaken baby syndrome - as Caucasian infants.

 Native mothers generally are less educated, which may decrease their willingness and ability to seek out and interpret parenting information, Gessner said.

But Alaska Natives report drinking half as much alcohol - linked to higher rates of infant mortality - as Caucasians during pregnancy, according to Gessner.

Seventy percent of Native mothers also are as likely to put infants to sleep on their backs instead of their stomachs, he said. That practice has helped cut SIDS cases in half nationally, he said.